Although joint reconstruction surgeries are relatively prevalent, they may not be routine for individuals with sickle cell disease. Patients with the blood disorder who undergo total knee replacement have a higher risk of complications, according to a new large-scale study, as reported by US News.
“SCD patients undergoing total knee replacement require a multidisciplinary approach and may be better served in specialized centers equipped to treat these complex medical patients,” said Dr. Senthil Sambandam, assistant professor of orthopedic surgery at University of Texas Southwestern Medical Center in Dallas and author of the study.
“These patients have a higher risk of postoperative complications requiring the involvement of various specialists, including nephrologists, pulmonologists, and hematologists,” he explained in a news release from UT Southwestern.
Bone and joint problems are prevalent among sickle cell patients. Approximately 100,000 Americans are affected by the disease. Over the years, as the life expectancy of these patients has increased, so has the proportion of patients requiring joint reconstruction.
The National Inpatient Sample database was used by researchers to identify patients who underwent total knee replacement between 2016 and 2019. Patients with sickle cell disease were separated from those without the condition.
More than 558 thousand patients underwent this surgery. Less than 1%, or 493 people, were identified as having sickle cell disease. A greater proportion of sickle cell patients were younger, male, and Black than non-sickle cell patients. Sickle cell patients had a substantially increased risk of developing acute kidney failure, requiring a blood transfusion, and developing deep vein thrombosis, according to the analysis.
Twenty percent to twenty-five percent of the patients experienced complications such as acute chest syndrome, pain crisis, or splenic sequestration crisis (spleen enlargement) around the time of surgery. The study discovered that this may have contributed to the longer hospital stays and higher health care costs.
Sambandam stated that the findings emphasize the significance of preventive strategies for sickle cell disease patients, such as patient education and joint health programs. The findings of the research were published in the Archives of Orthopaedic and Trauma Surgery.